2018 New Jersey Revised Statutes
Title 24 - FOOD AND DRUGS
Chapter 6F - Prescribing, administering or dispensing amygdalin (laetrile); immunity of physician; written informed request; form
Section 24:6F-1 - Prescribing, administering or dispensing amygdalin (laetrile); immunity of physician; written informed request; form

Section: 24:6F-1: Prescribing, administering or dispensing amygdalin (laetrile); immunity of physician; written informed request; form

No duly licensed physician shall be subject to any penalty or disciplinary action by any State agency or private professional organization solely for prescribing, administering or dispensing amygdalin, also known as laetrile or vitamin B-17, to a patient who has made a written request for such substance on the following form:

WRITTEN INFORMED REQUEST FOR PRESCRIPTION OF AMYGDALIN (LAETRILE) FOR MEDICAL TREATMENT

Patient's name Address Age Sex Name and address of prescribing physician


Malignancy, disease, illness or physical condition diagnosed for medical treatment by amygdalin (laetrile)


My physician has explained to me:

(a) That the manufacture and distribution of amygdalin (laetrile) has been banned by the Federal Food and Drug Administration.

(b) That neither the American Cancer Society, the American Medical Association, nor the Medical Society of New Jersey recommend use of amygdalin (laetrile) in the treatment of any malignancy, disease, illness or physical condition.

(c) That there are alternative recognized treatments for the malignancy, disease, illness or physical condition from which I suffer which he has offered to provide for me including: (Here describe)


That notwithstanding the foregoing, I hereby request prescription and use of amygdalin (laetrile) (a) in the medical treatment of the malignancy, disease, illness or physical condition from which I suffer [ ], or (b) as a dietary supplement [ ]. Check (a) or (b).

Patient or person signing for patient

Attest: Prescribing physician

L.1977, c. 318, s. 1, eff. Jan. 10, 1978.